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Neutropenic enterocolitis following treatment with cytosine arabinoside-containing regimens for hematological malignancies: A potentiating role for amsacrine

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Summary

A retrospective clinical study was performed to determine the clinical impact of neutropenic enterocolitis (NE) in adult patients with acute leukemia and non-Hodgkin's lymphoma treated with cytosine arabinoside (Ara-C)-containing regimens. The diagnosis of NE was restricted to conditions with clinical signs of peritonitis, ileus, or intestinal hemorrhage. Forty episodes of NE were noted during 461 Ara-C-containing courses (8.6%) in 36 of 211 patients (17%) over a 6-year period. Clinically, 18 cases of ileus, 16 cases of peritonitis, and 6 cases of intestinal hemorrhage were recognized as the most important presentation of NE. NE started about 2 weeks after the initiation of the chemotherapy and lasted for an average of 1 week. All patients had a profound neutropenia. The incidence of septicemia was higher during courses complicated by NE (p<0.001). All cases of NE were treated with conservative measures. The mortality was 22.5% and represented one' third of all therapy-related deaths during the pancytopenic period. The incidence of NE was significantly higher in courses consisting of high-dose Ara-C for 6 consecutive days when the drug was combined with amsacrine for 3 consecutive days (p<0.0001).

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Hematology, Leiden University, Center, Leiden, The Netherlands

    L. Th. Vlasveld, F. E. Zwaan, W. E. Fibbe & R. Willemze

  2. Department of Radiology, Leiden University, Center, Leiden, The Netherlands

    R. T. O. Tjon A. Tham

  3. Department of Pathology, Leiden University, Center, Leiden, The Netherlands

    P. M. Kluin

Authors
  1. L. Th. Vlasveld
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  2. F. E. Zwaan
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  3. W. E. Fibbe
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  4. R. T. O. Tjon A. Tham
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  5. P. M. Kluin
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  6. R. Willemze
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Vlasveld, L.T., Zwaan, F.E., Fibbe, W.E. et al. Neutropenic enterocolitis following treatment with cytosine arabinoside-containing regimens for hematological malignancies: A potentiating role for amsacrine. Ann Hematol 62, 129–134 (1991). https://doi.org/10.1007/BF01702926

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  • DOI: https://doi.org/10.1007/BF01702926

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